QuestionHello! First of all I want to thank you for all your answers you give to us.
A friend of mine (my best friend) is concerned because she wants to get pregnant.
Her blood type is A negative and she is concerned about what will happen when she gets pregnant.
She has had a surgical abortion when she was 17. Now she is 26.She is married and wants to have a baby! Does she have any chances to get pregnant again?
AnswerHello, Ana,
You're welcome.
The most risky situation is when a person has type O negative blood. That is when the mother is likely to form antibodies that attack her baby. Your friend should ask her doctor if having A negative blood is a problem. Normally, they don't give the Rho gam shot unless a woman is O negative, though. You are right that a surgical abortion can interfere with safely carrying a baby if the mother is O negative and the baby is not, and she did not receive a Rho gam shot at the time.
This is not the only consideration, however. About 14% of women who have a surgical abortion will never conceive again. The only thing I know to do about that is to plan to adopt. But a woman probably won't know for awhile if she is in that group. If a woman does not conceive within a year, she should consider the possibility. The other problem is that women who have had a surgical abortion may be prone to several possible medical problems. The first is tubal pregnancy. If the abortion caused scarring over the opening to the Fallopian tube where conception takes place, such that there is a smaller opening in the scar big enough for sperm, but not for the baby, then she can have a tubal pregnancy. This is a life-threatening condition that requires emergency surgery. The baby cannot survive. If a woman feels pain in the first few weeks, particularly on one side, then she should immediately see a doctor. If she feels pain, but the pain suddenly stops, she needs IMMEDIATE surgery. The second problem is repeat miscarriages. And the third is similar and caused by the same problem, and that is when a baby is born far too soon. This can lead to some fairly serious birth defects. For this reason, your friend needs to be getting prenatal care, and she needs to tell the doctor she has had a surgical abortion. She should ask him to teach her to recognize the onset of premature labor. If this occurs, she needs to get off her feet and elevate her lower body. The doctor may also want to do a cerclage on her. This is when the cervix is fastened shut. This is typically the preferred method of treatment when the surgical abortion caused significant damage to the cervix. When a surgical abortion is done, the process of opening the cervix usually causes damage. The cervix is tightly closed and not ready to open. The most common kind of damage is tiny tears in the flesh of the cervix. Such a cervix will be unable to support the weight of a full term baby. This is when cerclage is an appropriate treatment. So your friend needs to discuss this with the doctor as well.
Surgical abortion can also cause complications at the time of birth. The most common complications are prolonged labor and placenta previa. Placenta previa is when the placenta fastens close to the opening to the cervix, or over the opening. This happens because there is so much scarring in the upper part of the uterus that the baby cannot fasten there. Placenta previa can result in the placenta being torn loose from the surface of the uterus during labor, and can cause both mother and baby to hemorrhage to death. The treatment is Caesarian section. Usually, they will be able to tell if the placenta is in a bad position, through ultrasound, late in pregnancy. Prolonged labor may also make a Caesarian section necessary.
We will hope for the best for her. She should take good care of herself, and get really good prenatal care. She needs to let the doctor know she has had a surgical abortion. Let me know how things go with her, and be there and support her as best you can.
